Endokrinologie der Intensivmedizin

Kernaussagen

• Neuroendokrine Anpassungen an akute Stressoren sind im Laufe der Evolution selektioniert worden und müssen daher zunächst als positiv für das Überleben schwerer Krankheiten oder Traumen angesehen werden.

• Diese Anpassungen verändern sich im prolongierten Verlauf kritischer Erkrankungen. Unklar bleibt, welche der Adaptationen in dieser Phase irrelevant für das Überleben sind und welche sich positiv oder eher negativ auf das Outcome auswirken.

• Für Patienten auf chirurgischen Intensivstationen wird die Einstellung des Glukosespiegels auf Werte unter 8,3 mmol/l (< 150 mg/dl) empfohlen.

• Vom Einsatz von Wachstumshormonen bei Intensivpatienten wird von den Fachgesellschaften abgeraten.

• Weder die Therapie mit T3 noch mit T4 wird für die akute oder prolongierte Phase kritischer Erkrankungen für die tägliche Routine empfohlen. Der Einsatz von TRH ist bisher noch experimentell.

• Literatur

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